EP1795138B1 - Intramedullary nail for osteosynthesis - Google Patents

Intramedullary nail for osteosynthesis Download PDF

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Publication number
EP1795138B1
EP1795138B1 EP06301140A EP06301140A EP1795138B1 EP 1795138 B1 EP1795138 B1 EP 1795138B1 EP 06301140 A EP06301140 A EP 06301140A EP 06301140 A EP06301140 A EP 06301140A EP 1795138 B1 EP1795138 B1 EP 1795138B1
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EP
European Patent Office
Prior art keywords
nail
clip
screw
screws
holes
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Not-in-force
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EP06301140A
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German (de)
French (fr)
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EP1795138A1 (en
Inventor
Philippe Collin
Yann Julien
Laurent Beguin
Pierre Desmoineaux
Michel Colombier
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Genie Medical - Sgm Ste
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Genie Medical - Sgm Ste
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Publication of EP1795138A1 publication Critical patent/EP1795138A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7241—Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect

Definitions

  • the invention relates to the technical field of intramedullary nails osteosynthesis.
  • the invention relates to a nail for the treatment of fractures of the humeral head without tuberosity 3 or 4 fragments.
  • an osteosynthesis nail is intended to be engaged in the medullary canal of the bone in question by being attached thereto, in particular at the proximal portion, by means of screws engaged in through holes. formed in said proximal portion. These holes can be smooth or tapped. The screws engaged through the holes are usually screwed into the cancellous bone.
  • the nail can also be used for diaphyseal fractures or diaphyseal and proximal associated fractures. In this case, said screws can be engaged in holes formed at the distal portion of the nail and screwed into the cortex.
  • the nail made in the form of a hollow cylindrical rod, generally made of steel, may be rectilinear and have, substantially at its distal portion, cut sections to facilitate its introduction into the percutaneous approach bone.
  • the holes receiving the screws can be aligned or angularly offset in order to orient, in a corresponding manner, the screws in the cancellous bone as a function of the type of fracture to be treated and especially to strengthen the anti-tilt effect of the humeral head during its consolidation.
  • an osteosynthesis nail many technical improvements have been made in particular to reduce the micromotion that may result from different stresses to which the bone is subjected.
  • at least one of the holes receiving a screw in the proximal portion is smooth and has a transverse inner rod projecting inside said hole, so as to support the thread of the screw.
  • the invention proposes to solve in another way, on the one hand, the problem of wedging and centering of the nail in the medullary canal of the bone, particularly in metaphyseal part and on the other hand, the problem of the tilting of the humeral head in varisation under the effect of tuberosities traction to consolidate
  • an intramedullary nail according to the features of claim 1 was designed.
  • the reported means (s) is / are constituted (s) by one or more outer rings (s) fitted (s) on the periphery of said nail to be engaged (s) in the medullary canal, after impaction.
  • the means (s) reported (s) is / are constituted (s) by at least one ring and at least one staple having arrangements for the engagement of a common fastening screw in the proximal portion.
  • the fixing screw is locked in the transverse direction relative to the nail by a nut screw system whose particularity is that the nut is at a step.
  • the nail immobilization contrary to the arrangement developed in the patent FR 2784283 is obtained thanks to the thread of the nut made inside the hole of passage of the screw to immobilize the screw on the nail, the threaded hole having only one thread pitch.
  • Another problem to be solved by the invention is to facilitate the placement of the nail in the medullary canal by decreasing the opening and introducing a percutaneous approach.
  • the distal end of the nail is shaped like a square-type tip.
  • the intramedullary nail is made, in a manner perfectly known to those skilled in the art, from a cylindrical rod (1) of hollow section and made of metal in particular.
  • the proximal end (1a) of the nail (1) has arrangements for cooperating with, for example, a viewfinder.
  • the distal end (1b) is pointed, of the square type, to allow a percutaneous approach in order, in particular, to avoid making, at the proximal portion of the bone constituted for example by the humeral head, an opening or a bore.
  • the nail (1) cooperates, particularly at the proximal portion, with externally reported means capable of ensuring its centering and its lateral wedging in the medullary canal of the bone in question, the humerus for example.
  • externally reported means capable of ensuring its centering and its lateral wedging in the medullary canal of the bone in question, the humerus for example.
  • These means may be constituted by at least one ring or plug (2) shaped to be fitted on the outer periphery of the nail (1).
  • the outer diameter of the ring (2) is shaped to be wedged in the humeral channel for example, to ensure, concomitantly, the self-centering and wedging of the nail.
  • the proximal portion of the nail (1) can receive several rings (2) formed from a common sheath (3) adapted to be fitted on the periphery of said nail.
  • the sheath (3) has holes (3a) for the passage of cancellous bone screws (4) adapted to be engaged through holes (1c) which, in a perfectly known manner, has the proximal part of the nail (1). ).
  • the holes (1c) can be aligned or offset angularly, as indicated above.
  • the cancellous screws (4) are of any known and appropriate type.
  • the ring (s) (2) may be of resorbable material.
  • a staple (5) to ensure the setting and centering of the nail in the medullary canal of the bone, it is possible to use a staple (5).
  • This clip (5) has at least two branches (5a) and (5b) joined by a common part (5c) having arrangements for the engagement in particular of the cancellous screw (4).
  • the screw head may be threaded to obtain a rigid screw - nail - clip assembly.
  • the clip (1) is made of a flexible material including shape memory.
  • the staple is made of a rigid material. It is also observed that the rigid clip can act as a support thanks to the flattened shape of the branch, when the humeral head has tilted.
  • the nail (1) can be mounted in combination with the nail (1), the rings (2) and the clip (5).
  • the branches (5a) and (5b) of the clip are engaged around the sheath (3), in the gap left free by two rings.
  • the sheath (3) is pierced right through to allow the engagement of the screw (4).
  • the screw head (4) may be spherical or threaded with a differential pitch, in particular for bonding the staple - screw assembly.
  • the definition of the passage hole (1c) of the screw (4) is such that it has a thread of a pitch which acts as a nut / screw assembly for immobilizing the nail transversely relative to the screw.
  • the interest of the nut to one step allows to receive the soul of the screw without binding or inadvertent blocking ( Figures 7 and 8 ).
  • the nail (1) may be entirely rectilinear or have a curvature particularly at the proximal level.

Abstract

The nail has proximal and distal ends (1a, 1b) and cooperates, at the proximal end, with an outer unit, where the distal end is provided as a square type tip. The outer unit is constituted of rings (2) that are provided for being press fitted in an outer periphery of the nail. The rings are formed from a common socket (3) presenting holes (3a) for the passage of a cancellous bone screw (4) adapted to be engaged through holes (1c) which present proximal part of the nail.

Description

L'invention concerne le domaine technique des clous centromédullaires d'ostéosynthèse.The invention relates to the technical field of intramedullary nails osteosynthesis.

Plus particulièrement, l'invention concerne un clou pour le traitement des fractures de la tête humérale sans tubérositaires 3 ou 4 fragments.More particularly, the invention relates to a nail for the treatment of fractures of the humeral head without tuberosity 3 or 4 fragments.

D'une manière parfaitement connue pour un homme du métier, un clou d'ostéosynthèse est destiné à être engagé dans le canal médullaire de l'os considéré en y étant fixé, notamment en partie proximale, au moyen de vis engagées dans des trous débouchant formés dans ladite partie proximale. Ces trous peuvent être lisses ou taraudés. Les vis engagées au travers des trous sont généralement vissées dans l'os spongieux.
Le clou peut également être utilisé pour des fractures diaphysaires ou des fractures associées diaphysaires et proximales. Dans ce cas, lesdites vis peuvent être engagées dans des trous formés au niveau de la partie distale du clou et vissées dans la corticale.
Le clou, réalisé sous forme d'une tige cylindrique creuse, généralement en acier, peut être rectiligne et présenter, sensiblement au niveau de sa partie distale des pans coupés pour faciliter son introduction dans l'os en approche percutanée.In a manner perfectly known to a person skilled in the art, an osteosynthesis nail is intended to be engaged in the medullary canal of the bone in question by being attached thereto, in particular at the proximal portion, by means of screws engaged in through holes. formed in said proximal portion. These holes can be smooth or tapped. The screws engaged through the holes are usually screwed into the cancellous bone.
The nail can also be used for diaphyseal fractures or diaphyseal and proximal associated fractures. In this case, said screws can be engaged in holes formed at the distal portion of the nail and screwed into the cortex.
The nail, made in the form of a hollow cylindrical rod, generally made of steel, may be rectilinear and have, substantially at its distal portion, cut sections to facilitate its introduction into the percutaneous approach bone.

On observe également qu'en partie proximale les trous recevant les vis, peuvent être alignés ou décalés angulairement afin d'orienter, d'une manière correspondante, les vis dans l'os spongieux en fonction du type de fracture à traiter et surtout renforcer l'effet anti-basculement de la tête humérale pendant sa consolidation.It is also observed that in the proximal part, the holes receiving the screws can be aligned or angularly offset in order to orient, in a corresponding manner, the screws in the cancellous bone as a function of the type of fracture to be treated and especially to strengthen the anti-tilt effect of the humeral head during its consolidation.

A partir de cette conception de base, d'un clou d'ostéosynthèse, de nombreuses améliorations techniques ont été apportées notamment pour réduire les micromouvements susceptibles de résulter de différentes sollicitations auxquelles est soumis l'os. Par exemple, il ressort de l'enseignement du brevet FR 2.784.283 qu'au moins l'un des trous recevant une vis en partie proximale est lisse et présente transversalement une tige interne faisant saillie à l'intérieur dudit trou, de manière à faire office d'appui au filet de la vis. Ces dispositions permettent de bloquer le clou par rapport à la vis dans la direction axiale de cette dernière et entre le décentrage de l'implant.From this basic design, an osteosynthesis nail, many technical improvements have been made in particular to reduce the micromotion that may result from different stresses to which the bone is subjected. For example, it appears from the teaching of the patent FR 2 784.283 at least one of the holes receiving a screw in the proximal portion is smooth and has a transverse inner rod projecting inside said hole, so as to support the thread of the screw. These arrangements allow to lock the nail relative to the screw in the axial direction of the latter and between the decentering of the implant.

On peut citer également les documents WO 02/080790 qui concerne un clou centromédullaire dont la partie proximale reçoit une bague externe fixée par une patte à l'extérieur de la tête fémorale, US 2004/0122428 qui concerne un clou coopérant avec un moyen externe de centrage et DE 102 04 904 qui concerne un clou dont le calage s'effectue en partie distale.We can also mention the documents WO 02/080790 which concerns an intramedullary nail whose proximal portion receives an outer ring fixed by a tab on the outside of the femoral head, US 2004/0122428 concerning a nail cooperating with an external centering means and DE 102 04 904 which concerns a nail whose wedging takes place in distal part.

A partir de cet état de la technique, l'invention se propose de résoudre d'une autre façon, d'une part, le problème de calage et de centrage du clou dans le canal médullaire de l'os, notamment en partie métaphysaire et, d'autre part, le problème du basculement de la tête humérale en varisation sous l'effet des tractions des tubérosités à consoliderFrom this state of the art, the invention proposes to solve in another way, on the one hand, the problem of wedging and centering of the nail in the medullary canal of the bone, particularly in metaphyseal part and on the other hand, the problem of the tilting of the humeral head in varisation under the effect of tuberosities traction to consolidate

Pour résoudre ces problèmes, il a été conçu un clou centromédullaire conforme aux caractéristiques de la revendication 1.To solve these problems, an intramedullary nail according to the features of claim 1 was designed.

Dans une forme de réalisation de l'invention, le ou les moyens rapporté(s) est/sont constitué(s) par une ou des bagues externe(s) emmanchée(s) sur la périphérie dudit clou pour être engagée(s) dans le canal médullaire, après impaction.In one embodiment of the invention, the reported means (s) is / are constituted (s) by one or more outer rings (s) fitted (s) on the periphery of said nail to be engaged (s) in the medullary canal, after impaction.

Selon une autre forme de réalisation, le ou les moyens rapporté(s) est/sont constitué(s) par au moins une bague et au moins une agrafe présentant des agencements pour l'engagement d'une vis de fixation commune en partie proximale. La vis de fixation est bloquée dans le sens transversal par rapport au clou par un système vis écrou dont la particularité est que l'écrou est à un pas. L'immobilisation clou - vis contrairement à l'agencement développé dans le brevet FR 2784283 est obtenue grâce au filet de l'écrou réalisé à l'intérieur du trou de passage de la vis pour immobiliser la vis sur le clou, le trou fileté ne présentant qu'un pas de filet.According to another embodiment, the means (s) reported (s) is / are constituted (s) by at least one ring and at least one staple having arrangements for the engagement of a common fastening screw in the proximal portion. The fixing screw is locked in the transverse direction relative to the nail by a nut screw system whose particularity is that the nut is at a step. The nail immobilization contrary to the arrangement developed in the patent FR 2784283 is obtained thanks to the thread of the nut made inside the hole of passage of the screw to immobilize the screw on the nail, the threaded hole having only one thread pitch.

Un autre problème que se propose de résoudre l'invention est de faciliter la mise en place du clou dans le canal médullaire en diminuant l'ouverture d'introduction et en ayant une approche percutanée. Dans ce but, pour résoudre un tel problème, l'extrémité distale du clou est conformée en pointe du type carré.Another problem to be solved by the invention is to facilitate the placement of the nail in the medullary canal by decreasing the opening and introducing a percutaneous approach. For this purpose, in order to solve such a problem, the distal end of the nail is shaped like a square-type tip.

L'invention est exposée ci-après plus en détail à l'aide des figures des dessins annexés dans lesquels :

  • la figure 1 est une vue en perspective du clou avant mise en place de l'agrafe en matériau souple et engagement de la vis proximale ;
  • la figure 2 est une vue correspondant à la figure 1 après mise en place de l'agrafe et engagement de la vis proximale ;
  • la figure 3 est une vue en perspective du clou avant mise en place de l'agrafe selon une autre forme de réalisation ;
  • la figure 4 est une vue en perspective correspondant à la figure 3 après mise en place de l'agrafe souple et engagement de la vis proximale ;
  • la figure 5 est une vue en perspective d'une autre forme de réalisation du clou, avant mise en place de bagues de centrage montées en combinaison avec une agrafe rigide maintenues ensemble par une vis à os spongieux ;
  • la figure 6 est une vue en perspective correspondant à la figure 5 après mise en place des bagues de centrage et de l'agrafe maintenue par les vis à os spongieux.
  • la figure 7 est une vue transversale de la définition d'un des trous du clou ;
  • la figure 8 est une vue transversale du trou du clou avec sa vis de fixation précisant l'intérêt de l'écrou à un pas.
The invention is described below in more detail with reference to the figures of the accompanying drawings, in which:
  • the figure 1 is a perspective view of the nail before placement of the staple of flexible material and engagement of the proximal screw;
  • the figure 2 is a view corresponding to the figure 1 after insertion of the staple and engagement of the proximal screw;
  • the figure 3 is a perspective view of the nail before placing the clip according to another embodiment;
  • the figure 4 is a perspective view corresponding to the figure 3 after placement of the flexible clip and engagement of the proximal screw;
  • the figure 5 is a perspective view of another embodiment of the nail, before placement of centering rings mounted in combination with a rigid clip held together by a cancellous bone screw;
  • the figure 6 is a perspective view corresponding to the figure 5 after placement of the centering rings and the clip held by the cancellous bone screws.
  • the figure 7 is a transverse view of the definition of one of the nail holes;
  • the figure 8 is a transverse view of the nail hole with its fixing screw indicating the interest of the nut at a step.

Le clou centromédullaire est réalisé, d'une manière parfaitement connue pour un homme du métier, à partir d'une tige cylindrique (1) de section creuse et réalisée en métal notamment. L'extrémité proximale (1a) du clou (1) présente des agencements pour coopérer avec, par exemple, un viseur.
Selon l'invention, l'extrémité distale (1b) est conformée en pointe, du type carré, pour permettre une approche percutanée afin, notamment, d'éviter de réaliser, au niveau de la partie proximale de l'os constitué par exemple par la tête humérale, une ouverture ou un alésage.The intramedullary nail is made, in a manner perfectly known to those skilled in the art, from a cylindrical rod (1) of hollow section and made of metal in particular. The proximal end (1a) of the nail (1) has arrangements for cooperating with, for example, a viewfinder.
According to the invention, the distal end (1b) is pointed, of the square type, to allow a percutaneous approach in order, in particular, to avoid making, at the proximal portion of the bone constituted for example by the humeral head, an opening or a bore.

Selon une autre caractéristique, le clou (1) coopère, notamment au niveau de la partie proximale, avec des moyens externes rapportés aptes à assurer son centrage et son calage latéral dans le canal médullaire de l'os considéré, l'humérus par exemple. Ces moyens peuvent être constitués par au moins une bague ou bouchon (2) conformé pour être emmanché sur la périphérie externe du clou (1). Le diamètre externe de la bague (2) est conformé pour être coincé dans le canal huméral par exemple, pour assurer, d'une manière concomitante, l'auto-centrage et le calage du clou.According to another characteristic, the nail (1) cooperates, particularly at the proximal portion, with externally reported means capable of ensuring its centering and its lateral wedging in the medullary canal of the bone in question, the humerus for example. These means may be constituted by at least one ring or plug (2) shaped to be fitted on the outer periphery of the nail (1). The outer diameter of the ring (2) is shaped to be wedged in the humeral channel for example, to ensure, concomitantly, the self-centering and wedging of the nail.

Comme le montrent les figures 5 et 6, la partie proximale du clou (1) peut recevoir plusieurs bagues (2) formées à partir d'un fourreau commun (3) apte à être emmanché sur la périphérie dudit clou. Le fourreau (3) présente des trous (3a) pour le passage des vis à os spongieux (4) aptes à être engagées au travers de trous (1c) que présente, d'une manière parfaitement connue, la partie proximale du clou (1). Les trous (1c) peuvent être alignés ou décalés angulairement, comme indiqué précédemment. De même, les vis à spongieux (4) sont de tout type connu et approprié. La ou les bague(s) (2) peu(ven)t être en matériau résorbable.As shown by figures 5 and 6 , the proximal portion of the nail (1) can receive several rings (2) formed from a common sheath (3) adapted to be fitted on the periphery of said nail. The sheath (3) has holes (3a) for the passage of cancellous bone screws (4) adapted to be engaged through holes (1c) which, in a perfectly known manner, has the proximal part of the nail (1). ). The holes (1c) can be aligned or offset angularly, as indicated above. Similarly, the cancellous screws (4) are of any known and appropriate type. The ring (s) (2) may be of resorbable material.

Selon une autre forme de réalisation (figures 1 à 4), pour assurer le calage et le centrage du clou dans le canal médullaire de l'os, on peut utiliser une agrafe (5). Cette agrafe (5) présente au moins deux branches (5a) et (5b) réunies par une partie commune (5c) présentant des agencements pour l'engagement notamment de la vis à spongieux (4). Dans une variante, la tête de vis peut être filetée afin d'obtenir un ensemble rigide vis - clou - agrafe.
Aux figures 1 et 2, l'agrafe (1) est réalisée dans un matériau souple notamment à mémoire de forme.
Aux figures 3 et 4, l'agrafe est réalisée dans un matériau rigide. On observe également que l'agrafe rigide peut faire office d'appui grâce à la forme aplatie de la branche, quand la tête humérale a basculé.According to another embodiment ( Figures 1 to 4 ), to ensure the setting and centering of the nail in the medullary canal of the bone, it is possible to use a staple (5). This clip (5) has at least two branches (5a) and (5b) joined by a common part (5c) having arrangements for the engagement in particular of the cancellous screw (4). Alternatively, the screw head may be threaded to obtain a rigid screw - nail - clip assembly.
To the Figures 1 and 2 , the clip (1) is made of a flexible material including shape memory.
To the Figures 3 and 4 the staple is made of a rigid material. It is also observed that the rigid clip can act as a support thanks to the flattened shape of the branch, when the humeral head has tilted.

Eventuellement, on peut monter en combinaison avec le clou (1), les bagues (2) et l'agrafe (5). Dans ce cas, comme le montrent les figures 5 et 6, les branches (5a) et (5b) de l'agrafe sont engagées autour du fourreau (3), dans l'intervalle laissé libre par deux bagues. Dans ce cas, le fourreau (3) est percé de part en part pour permettre l'engagement de la vis (4).Optionally, it can be mounted in combination with the nail (1), the rings (2) and the clip (5). In this case, as shown by the figures 5 and 6 , the branches (5a) and (5b) of the clip are engaged around the sheath (3), in the gap left free by two rings. In this case, the sheath (3) is pierced right through to allow the engagement of the screw (4).

A noter que la tête de vis (4) peut être sphérique ou filetée à pas différentiel, notamment pour lier l'ensemble agrafe - vis.It should be noted that the screw head (4) may be spherical or threaded with a differential pitch, in particular for bonding the staple - screw assembly.

La définition du trou de passage (1c) de la vis (4) est telle qu'elle présente un filet de un pas qui fait office d'ensemble écrou/vis pour immobiliser transversalement le clou par rapport à la vis. L'intérêt de l'écrou à un pas permet de recevoir l'âme de la vis sans grippage ou blocage intempestif (figures 7 et 8).The definition of the passage hole (1c) of the screw (4) is such that it has a thread of a pitch which acts as a nut / screw assembly for immobilizing the nail transversely relative to the screw. The interest of the nut to one step allows to receive the soul of the screw without binding or inadvertent blocking ( Figures 7 and 8 ).

Le clou (1) peut être entièrement rectiligne ou présenter une courbure notamment au niveau proximal.The nail (1) may be entirely rectilinear or have a curvature particularly at the proximal level.

Les avantages ressortent bien de la description.The advantages are apparent from the description.

Claims (9)

  1. Centro-medullary nail for osteosynthesis intended to be engaged in the medullary canal of a bone by being secured thereto in the proximal, and possibly distal, part, by screws (4), said nail having, in its proximal part (1a), one or more means capable, on the one hand, of centring and laterally wedging said nail (1) in said canal and, on the other hand, of rigidifying the humeral head relative to the body of the bone,
    characterized in that the added means is/are constituted by a clip or a plurality of clips (5).
  2. Nail as claimed in claim 1, characterized in that the clip (5) has at least two branches (5a) and (5b) joined by a common part (5c) having arrangements for the engagement or attachment of the attachment screws (4) in the proximal part.
  3. Nail as claimed in any one of claims 1 and 2, characterized in that the clip (5) is made out of a shape-memory flexible material.
  4. Nail as claimed in any one of claims 1 and 2, characterized in that the clip (5) is made out of a rigid material.
  5. Nail as claimed in claim 1, characterized in that the added means is/are constituted by at least one bush (2) and at least one clip (5) having arrangements for the engagement of a common attachment screw (4) in the proximal part.
  6. Nail as claimed in claim 5, characterized in that, where a plurality of bushes (2) is involved, these are formed on the basis of a sleeve (3) capable of being fitted onto the periphery of said nail (1), the branches (5a) and (5b) of the clip being engaged around the sleeve (3), in the gap left free by two bushes, said sleeve (3) having through holes (3a) for the screws (4) in correspondence with holes (1c) in the nail.
  7. Nail as claimed in claim 6, characterized in that the sleeve (3) is made out of an absorbable material.
  8. Nail as claimed in any one of claims 1 to 7, characterized in that the distal end (1b) of the nail is in the shape of a square form pointed tip to enable a percutaneous approach.
  9. Nail as claimed in claim 1, characterized in that the clearance hole or holes (1c) receiving the screw or screws (4) has/have a one pitch thread which acts as a nut-screw assembly.
EP06301140A 2005-11-09 2006-11-09 Intramedullary nail for osteosynthesis Not-in-force EP1795138B1 (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR0553393A FR2892916B1 (en) 2005-11-09 2005-11-09 OSTEOSYNTHESIS CENTROMEDULAR NAIL

Publications (2)

Publication Number Publication Date
EP1795138A1 EP1795138A1 (en) 2007-06-13
EP1795138B1 true EP1795138B1 (en) 2010-03-10

Family

ID=36968820

Family Applications (1)

Application Number Title Priority Date Filing Date
EP06301140A Not-in-force EP1795138B1 (en) 2005-11-09 2006-11-09 Intramedullary nail for osteosynthesis

Country Status (4)

Country Link
EP (1) EP1795138B1 (en)
AT (1) ATE460122T1 (en)
DE (1) DE602006012783D1 (en)
FR (1) FR2892916B1 (en)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102007029090A1 (en) * 2007-06-21 2008-12-24 Plus Orthopedics Ag Device for osteosynthesis, particularly bone fracture near joint, has pin for implantation into abarticular bone, and proximal longitudinal ring element provided for implantation into bone fragment near joint
JP6588127B1 (en) * 2018-05-18 2019-10-09 メディカルサン株式会社 Intramedullary nail auxiliary device and intramedullary nail

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB0102488D0 (en) * 2001-01-31 2001-03-14 Grampian Univ Hospitals Bone Fixture Apparatus
DE20105775U1 (en) * 2001-04-03 2001-06-07 Joos Martin Bone nail for surgical purposes
DE10204904A1 (en) * 2002-02-06 2003-08-14 Wittenstein Ag Device, in particular intramedullary nail and / or sleeve for insertion into long bones
US6755866B2 (en) * 2002-08-20 2004-06-29 Depuy Products, Inc. Prosthetic stem with bearings

Also Published As

Publication number Publication date
EP1795138A1 (en) 2007-06-13
FR2892916A1 (en) 2007-05-11
ATE460122T1 (en) 2010-03-15
FR2892916B1 (en) 2008-12-05
DE602006012783D1 (en) 2010-04-22

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